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ETHICAL PRINCIPLES & ISSUES IN PUBLIC HEALTH

ETHICAL PRINCIPLES & ISSUES IN PUBLIC HEALTH. Dept. of Public Health. Learning Objectives. To review ethical principles and issues in public health. Required reading:

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ETHICAL PRINCIPLES & ISSUES IN PUBLIC HEALTH

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  1. ETHICAL PRINCIPLES & ISSUES IN PUBLIC HEALTH Dept. of Public Health

  2. Learning Objectives • To review ethical principles and issues in public health Required reading:  Calman KC and Downie RS. Ethical principles and ethical issues in public health. In: Detels R and Breslow L, eds. Oxford Textbook of Public Health, 4th edition. New York: Oxford University Press, 2002, pp. 387- 400

  3. Principles of Health Care Ethics • Beneficence the obligation of health care providers to help people in need • Non-maleficence the duty of health care providers to do no harm

  4. Principles of Health Care Ethics (cont’d) • Autonomy • the right of a person to choose & follow his or her own plan of life & action • Justice (or equity) • the ethical concept of treating everyone in a fair manner • Utility • maximizing the total benefits for the populations involved

  5. Issue to discuss:What is ‘equity’ & what is ‘equality’?

  6. General agreement • Each person should have an equal right to basic liberties, e.g. freedom of speech, assembly, & thought • Each person has a right to equal opportunities, e.g. education

  7. If the resources are fixed then they could be distributed: • to each person an equal share • to each person according to individual needs • to each person according to individual efforts • to each person according to societal contributions • to each person according to merit

  8. EQUITY • Equal resources/use of services • Equal health • Fair innings • Equal access/utilization according to need • Treatment according capacity to benefit

  9. Rosenau & Roemer (1999): The general assumptions of a public health ethic: • Provision of care on the basis of health need without regard to race, religion, gender, sexual orientation, or ability to pay

  10. Rosenau & Roemer (1999): 2. Equity in distribution of resources, giving due regard to vulnerable groups in the population, e.g. ethnic minorities, migrants, children, pregnant women, the poor, the handicapped 3. Respect for human rights, including the right to autonomy, privacy, liberty, and health & well-being, keeping in mind social justice considerations

  11. Issues • What tensions exist b/w protection of the public health & protection of individual rights? • How should scarce resources be allocated & used? • What should be the balance b/w expenditures & quality of life in cases of chronic & terminal illness?

  12. Issues (cont’d) • What are appropriate limits on the use of expensive medical technology? • What obligations do health care insurers & providers have to meet the ‘right to know’ of patients as consumers? • What responsibility exists for the young to finance health care for older persons? • What obligation exists for government to protect the most vulnerable sectors of society?

  13. Thank you…..

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